Establishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammation

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dc.contributor.authorBawua, Abigail S. A.en_ZA
dc.contributor.authorIchihara, Kiyoshien_ZA
dc.contributor.authorKeatley, Rosemaryen_ZA
dc.contributor.authorArko-Mensah, Johnen_ZA
dc.contributor.authorDei-Adomakoh, Yvonneen_ZA
dc.contributor.authorAyeh-Kumi, Patrick F.en_ZA
dc.contributor.authorErasmus, Rajiven_ZA
dc.contributor.authorFobil, Juliusen_ZA
dc.date.accessioned2022-09-15T09:10:09Zen_ZA
dc.date.available2022-09-15T09:10:09Zen_ZA
dc.date.issued2020-09en_ZA
dc.descriptionCITATION: Bawua, A. et al. 2020. Establishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammation. International journal of laboratory hematology, 42(6):705–717. doi:10.1111/ijlh.13296en_ZA
dc.descriptionThe original publication is available at https://onlinelibrary.wiley.com/journal/1751553xen_ZA
dc.description.abstractBackground: In Ghana, diagnostic laboratories rely on reference intervals (RIs) provided by manufacturers of laboratory analyzers which may not be appropriate. This study aimed to establish RIs for hematological parameters in adult Ghanaian population. Methods: This cross-sectional study recruited 501 apparently healthy adults from two major urban areas in Ghana based on the protocol by IFCC Committee for Reference Intervals and Decision Limits. Whole blood was tested for complete blood count (CBC) by Sysmex XN-1000 analyzer, sera were tested for iron and ferritin by Beckman-Coulter/AU480, for transferrin, vitamin-B12, and folate was measured by Centaur-XP/Siemen. Partitioning of reference values by sex and age was guided by “effect size” of between-subgroup differences defined as standard deviation ratio (SDR) based on ANOVA. RIs were derived using parametric method with application of latent abnormal values exclusion method (LAVE), a multifaceted method of detecting subjects with abnormal results in related parameters. Results: Using SDR ≥ 0.4 as a threshold, RIs were partitioned by sex for platelet, erythrocyte parameters except mean corpuscular constants, and iron markers. Application of LAVE had prominent effect on RIs for majority of erythrocyte and iron parameters. Global comparison of Ghanaian RIs revealed lower-side shift of RIs for leukocyte and neutrophil counts, female hemoglobin and male platelet count, especially compared to non-African countries. Conclusion: The LAVE effect on many hematological RIs indicates the need for de-liberate secondary exclusion for proper derivation of RIs. Obvious differences in Ghanaian RIs compared to other countries underscore the importance of country-specific RIs for improved clinical decision-making.en_ZA
dc.description.urihttps://onlinelibrary.wiley.com/doi/10.1111/ijlh.13296en_ZA
dc.description.versionPublishers versionen_ZA
dc.format.extent13 pagesen_ZA
dc.identifier.citationBawua, A. et al. 2020. Establishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammation. International journal of laboratory hematology, 42(6):705–717. doi:10.1111/ijlh.13296en_ZA
dc.identifier.issn1751-553X (online)en_ZA
dc.identifier.issn1751-5521 (print)en_ZA
dc.identifier.otherdoi:10.1111/ijlh.13296en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/125734en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherWileyen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectComplete blood countsen_ZA
dc.subjectIron markersen_ZA
dc.subjectLatent abnormal values exclusion methoden_ZA
dc.subjectLatent anemiaen_ZA
dc.subjectMultiple regression analysisen_ZA
dc.subjectParametric methoden_ZA
dc.subjectSD‐ratioen_ZA
dc.subjecten_ZA
dc.subjecten_ZA
dc.subjecten_ZA
dc.titleEstablishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammationen_ZA
dc.typeArticleen_ZA
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